What is trigger finger or trigger thumb?
A complex system of tendons, tissue and bone work together the move your fingers and thumbs. Tendons in your hand allow you to bend your fingers and thumbs. These tendons run through a tunnel of tissue called a "sheath". The tunnels are quite narrow, and if tendons swell up, they become stuck resulting in what’s known as trigger finger or trigger thumb.
Trigger finger or trigger thumb are relatively common, often occurring as you get older. Sometimes it can be caused by trauma to the hand, or associated with diseases such as diabetes, rheumatoid arthritis or kidney disease.
Early on, trigger finger or trigger thumb causes stiffness, pain and swelling. As it progresses your finger or thumb may bend and remain stuck there. When this happens, surgery for trigger finger or trigger thumb repair is recommended.
Who will need trigger finger or trigger thumb surgery?
The reasons for considering this surgery will be determined by the effect the symptoms have on your everyday life. Some of them may include:
- You have painful, swollen or stiff hands and cannot make a complete fist.
- There is a popping sensation as you move your finger or thumb.
- You have small, tender bumps at the base of your triggered finger or thumb.
- Your finger or thumb is stuck in a bent position. Sometimes this may suddenly “pop” straight.
- To straighten your finger or thumb you may have to force it with your other hand.
- You may have had a trauma to your hand and trigger finger or trigger thumb is developing due to scar tissue.
The first step is to make an appointment to see Dr McMillan.
You will meet Dr McMillan at his private rooms in Fernbrae House, Dunedin or in Invercargill to review your trigger finger or trigger thumb and discuss the best surgical options. This is an important step, not only gaining an understanding of the expected surgical outcomes but also developing your relationship with Dr McMillan as you work together to establish better function for your hand.
During this consultation, if you have had trauma to your hand causing the trigger finger or trigger thumb then Dr McMillan will review with you the options for releasing any potential adhesions (where things have become stuck) for better function long term. It will also be an opportunity to review if any further reconstructive work that would be of benefit.
Once you have decided on what is to be done, a date will be booked for you at Mercy Hospital, Dunedin to have your trigger finger or trigger thumb surgery.
Depending on how extensive the surgery will be, the procedure may be done under general or local anaesthetic.
Once you are asleep, or the area is numbed, a cut will be made at the site of the stuck tendon (more often than not this will be in the palm of your hand). Once the tendon sheath is visible, it is divided. The division creates more space and means your tendon will now be able to move freely in the tunnel.
Any other release of adhesions or reconstruction that you will have decided on will also be performed at this stage. The cuts in your hand will be sutured.
Dressings will then be placed over the suture lines and your hand will be wrapped in a bandage.
Trigger finger or trigger thumb surgery is usually a day surgery procedure. You may not need to stay overnight at the hospital.
Relief of the symptoms of trigger finger or trigger thumb should be felt immediately after surgery.
Skin healing will occur over the first week and you may experience some discomfort and tenderness around the surgery area.
To assist in the swift recovery, it is important to engage in physiotherapy after trigger finger or trigger thumb surgery, to improve range of motion and reduce stiffness.
It is not uncommon for there to be pain, stiffness and swelling for about a month after surgery. This will fade over time and the full use of your hand will return.
Grip and strength to your hand are expected to return about 4-6 weeks after trigger finger or trigger thumb surgery.
Depending on what type of work you do you may need up to 6 weeks off work to allow time to regain your ability and strength to use your hand to grip again.
Risks and complications
As with all surgical procedures there are risks and potential complications with trigger finger or trigger thumb surgery. Dr McMillan will discuss all of these with you during your consultation and answer your questions.
There is a cost to having trigger finger or trigger thumb surgery done privately. The exact figure will depend on a range of factors but generally the cost is between $1,100 and $1,600.
If you have trigger finger or trigger thumb start the journey to better function for you and your hand; get in contact to make an initial consultation with Dr McMillan about surgical treatment.